Last month, HealthEast Medical Transportation told South St. Paul and West St. Paul that it plans to take over all ambulance transportation in those cities starting next year.

The decision was a financial and morale blow to the South Metro Fire Department, which last year received $240,000 through its contract with HealthEast for providing basic life-support ambulance service. HealthEast was able to make such a move because it holds the license for ambulance service in those areas.

About the same time that HealthEast announced its decision, two lawmakers from the north suburbs were preparing legislation aimed at giving cities more control over who provides ambulance transportation.

Three bills introduced last week by state Rep. Linda Runbeck, R-Circle Pines, and state Sen. Roger Chamberlain, R-Lino Lakes, would amend a three-decades-old law that gives the Emergency Medical Services Regulatory Board authority to designate who gets the ambulance transportation licenses for primary service areas.

The legislation would allow local governments to choose who provides ambulance transportation in their areas, whether it’s a company such as HealthEast or the cities themselves.

Any change to a license is considered by the state regulatory board and these requests follow requirements in statute, said Pamela Biladeau, the board’s executive director.

But since primary service areas were developed during the early 1980s, no city or private ambulance transportation provider has been successful in acquiring a license in an area that already had coverage, according to the regulatory board, though the board has received just one application.

“Cities have control over many things,” said Jerry Streich, fire chief of the Centennial Fire District, which provides firefighting and first-responder services for Centennial, Circle Pines and Lino Lakes. “They have a say about the police and fire service they receive and even what garbage trucks are going to service their area. But we don’t have a lot of say of what ambulance service provider is going to be covering our area.”

Laura Olson, director of HealthEast Medical Transportation, said the current system works.

The regulatory board ensures that communities receive ambulances in a timely and efficient manner — and that standards are met, Olson said.

“Any proposal to disrupt the (primary service area) structure would result in disruption of quality ambulance services to communities, fragmented coverage and possibly lower-quality care,” she said.

Olson noted that similar legislation previously has failed to gain traction at the Capitol.

The proposed legislation also aims to make ambulance transportation data public, including response times, the number of people served and the cost of service.

Cities also would be able to charge a fee to ambulance providers as a way to recoup taxpayer money now used for first-response services, the 911 system and dispatch centers.

Eagan Fire Chief Mike Scott said he would like cities to be able to choose an ambulance provider.

“I always look at the quality of service and what’s best for the citizens,” he said. “If we’re not happy with the quality of service from an ambulance provider, we should be able to go to our city council and say: ‘Hey this isn’t working out. Let’s go out for bid.’ And we can’t do that. I think that’s pretty crazy.”

Currently, ambulance providers “hold all the cards,” he said.

“Right now, we can’t say: ‘If you don’t improve on x, y and z, we will pull the plug,’ ” he said. “Right now, if you bring something like that up, what’s the carrot?”

St. Paul, Woodbury, Oakdale, Burnsville and Maplewood are among the few metro-area cities that hold licenses to provide ambulance transportation.

Streich said the three city councils from the Centennial Fire District have passed resolutions supporting legislation for more local control.

“This isn’t about the people — the medics — because they work really hard and they do a great job out there,” Streich said. “This is about not having a choice and how taxpayers are subsidizing the entire system for somebody to collect the revenue.”

One drawback to the current arrangement is that cities do not have a good handle on the day-to-day operations of private ambulance providers, such as who is on shift and when they perform hospital transfers out of the area, Streich said.

He said that despite population growth, the Centennial Fire District has the same number of ambulances serving residents — two — as it did in 1985, when the district was formed.

HealthEast always has held the primary service area license for much of Dakota County. In addition to South St. Paul and West St. Paul, the license covers Eagan, Inver Grove Heights, Mendota Heights, Rosemount and three smaller cities.

But HealthEast’s working relationship with the South Metro Fire Department, which dates to the 1980s, is an arrangement unlike anywhere else in the state.

When a resident makes a call for medical help, South Metro Fire responds and begins basic patient care and transportation, if needed. A HealthEast ambulance crew also shows up and performs advanced life-support care and transport, if required. HealthEast then bills the patient for their transport.

In explaining its decision last month to cut ties with South Metro, Olson, from HealthEast, said providing emergency medical services is “our expertise.”

It caught local officials off-guard, including state Sen. Jim Metzen, D-South St. Paul, who said last week that the decision “really ticked me off” and prompted him to call a meeting with HealthEast officials.

“Certainly, he’s disappointed, and that didn’t surprise us … and we know that South Metro is as well,” Olson said. “We certainly respect their concerns.”

Another meeting is scheduled this week, which Olson said is meant to “keep the dialogue open.” But HealthEast is firm in its decision, she said.

“At this point, that’s our stance,” she said. “And what we want to stress is that we have standards we want to meet. And we want to make sure there’s high-quality and safe and appropriate care for the community. We believe the best way to deliver that is for HealthEast ambulance to provide that service.”

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